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Fructose consumption has increased significantly during the past decades - in particular by using added sugar in food and beverages, either sugars containing free fructose, but also sugars containing fructose in bound form (e.g. sucrose). The metabolism of fructose exhibits distinct differences compared to the metabolism of glucose. Association studies performed in the past years suggest an association of fructose consumption and adverse effects on metabolism. Intervention studies, conducted in part with healthy individuals, could prove such effects and deliver explanations of the mechanisms leading to these adverse effects. A reduction of consumption of added fructose should be recommended, but there is no evidence to support a restriction of fruit consumption (as a natural source of fructose). [ABSTRACT FROM AUTHOR]

Dyslipidemia is one of the main modifiable cardiovascular risk factors. There is strong evidence for the efficacy of lipid-lowering drugs in secondary pre vention, as well as in primary prevention for patients at high cardiovascular risk. In primary prevention, indication for lipid-lowering interventions should be based on an individual assessment of the cardiovascular risk and on the LDL cholesterol level, despite less strong evidence for the efficacy of drug-based interventions in low risk patients. Treatment consists of statins, as well as lifestyle modifications such as body weight control and increased physical exercise. The latter constitute the primary intervention in patients at low cardiovascular risk. Secondary dyslipidemias due to an underlying medical condition and familial dyslipidemias such as Familial Hypercholesterolemia and Familial Combined Hyperlipidemia should be identified and treated accordingly, taking into account that the risk scoring systems are not appropriate in these situations. [ABSTRACT FROM AUTHOR]

Statins are effective drugs for treatment and prevention of cardiovascular diseases. Besides their lipid-lowering properties, statins act through multiple pleiotropic effects including vasoprotective mechanisms, effects on coagulation, anti-inflammatory properties and stabilization of atherosclerotic plaques. In recent years many studies have investigated the effects of statins administered to patients in the perioperative period. Results indicate that the perioperative use of statins is beneficial, most of all for patients with a high cardiovascular risk profile. However, most study designs are retrospective and vulnerable to systematic bias. The number of randomized controlled trials is very limited and include only low numbers of patients. Currently it is not known when perioperative treatment with statin should be started and how long it should be continued postoperatively to reach optimal protective effects. A pre-existing statin therapy should be continued perioperatively because discontinuation leads to a higher rate of complications in the perioperative period. Larger randomized controlled trials are therefore necessary to evaluate the efficiency and the safety of perioperative statin use, especially for patients with a low or intermediate cardiovascular risk profile. [ABSTRACT FROM AUTHOR]

Dyslipidemia is one of the most important cardiovascular risk factors. Accordingly preventive measures to normalize lipids are of great importance. The indication for a lipid lowering therapy according to current guidelines focuses on the identification of a patient's global risk, i.e. the contribution of all major cardiovascular risk factors. The selection of the lipid lowering therapy should be appropriate for the kind of lipid disorder. This may be a special challenge with respect to target values and safety aspects. Statins in monotherapy are generally considered safe drugs. Higher dosages may be associated with liver toxicity and muscle problems. Lifestyle management should underpin all lipid management strategies. [ABSTRACT FROM AUTHOR]

The adipose tissue stores excess energy but also produces a series of substances including cytokines (adipocytokines) which participate in regulatory processes. The physiologic and pathophysiologic relevance of these factors has only recently been described in more detail. Defects in adiponectin as well as overproduction of free fatty acids play an important role in the development of insulin resistance typical for obesity. Rare forms of obesity or lipodystrophy can now be explained by defects in the leptin system. The contribution of adipose tissue and its cytokines to the relationship between inflammation and the metabolic syndrome is currently under investigation. [ABSTRACT FROM AUTHOR]